Decline in blood loss with use of tranexamic acid in cases of hysterectomy: A retrospective observational study in a teaching hospital of central India

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Original Article

Author :

Sapna Bajaj Jain, Shikha

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Abstract :

Introduction: Hysterectomy the most commonly performed gynaecological surgery world over is mostly a planned surgery commonly done for benign uterine conditions, though relatively high rates of complications have been reported. Blood loss during surgery seems to be a major complication. Anaemia being prevalent in Indian women, adds to the risk of prolong recovery time and postoperative morbidity with excessive blood loss intra operatively. Tranexamic acid (TXA) being an anti fibrinolytic agent have been found to decrease blood loss and requirement of blood transfusion in various surgical procedures and aids in better recovery. Objective: To find the effectiveness of tranexamic acid in decreasing blood loss in patients undergoing hysterectomy for benign indications and the need for blood transfusion. Meterials and Methods: Type of study- Retrospective observational study over a period of 1 year in 200 patients. Study was conducted in Obstetrics and Gynaecology department of L.N. medical college, J.K hospital and research centre Bhopal. Approval for conducting study from ethical committee of hospital was taken. A retrospective analysis of all patients record was done who underwent hysterectomy for benign indications over the study period of one year and patient were sorted out in two groups, one (group 1) who received tranexamic acid (TXA) during surgery and other one (group 2) who did not receive TXA during surgery. Outcome of the study was assessed on following parameters - amount of blood lost (measurement of blood loss was done by the amount of blood collected in suction bottle and soiled mops), postoperative haemoglobin level after 24 hours of surgery, blood transfusion requirement, duration of hospital stay. Results: Significantly less intraoperative loss of blood and need for blood transfusion was found in group 1 as compared to group 2. (P=0.0001). Conclusion: In the present study we concluded that a single dose of tranexamic acid given during surgery significantly reduces the blood loss, operating time and need for blood transfusion in patients undergoing hysterectomy for benign indications. Tranexamic acid being an anti fibrinolytic agent can be safely recommended as prophylactic measure for reducing blood loss in hysterectomies specially in low resource setting.

Keyword :

Anti fibrinolytic, Tranexamic acid, Hysterectomy, Intraoperative blood loss, Menorrhagia.
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